Relationship of aspiration pneumonia to cognitive impairment and oral condition: a cross-sectional study
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The objective of this study was to investigate the relationship of the incidence of aspiration pneumonia to cognitive impairment and the oral condition.
Materials and methods
A total of 1174 elderly patients were analyzed in a cross-sectional study. Cognitive function was evaluated by the Clinical Dementia Rating scale and the oral condition was evaluated by inspection and palpation. Swallowing was examined in 196 patients by video-endoscopic evaluation. The Mann-Whitney U test or chi-square test was used for statistical analysis. Conditional logistic regression analysis was performed to compute the odds ratio (OR) and 95% confidence interval (CI).
Loss of posterior occlusion, impaired tongue movements, and impaired cognition were factors significantly related to aspiration pneumonia. The incidence of aspiration pneumonia was higher in patients with both cognitive impairment and loss of posterior occlusion compared with those having either factor alone (OR: 5.16). There was no statistical association between impaired swallowing and the incidence of aspiration pneumonia in elderly patients with normal cognitive function (cognitive impairment, OR: 3.45; normal function, OR: 0.94).
Co-existence of cognitive impairment and oral frailty significantly enhances the risk of aspiration pneumonia.
Early and simple evaluation of the oral condition and cognitive function can predict the risk of aspiration pneumonia.
KeywordsAspiration pneumonia Cognitive impairment Oral frailty Elderly patients
The authors thank the medical staff of Tottori Municipal Hospital and Naruto Seagull Hospital for their assistance.
This study was supported by a Grant-in-Aid for Scientific Research (B) (No. 15H05054) from the Japan Society for the Promotion of Science.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This study was approved by the ethics committee of Tottori Municipal Hospital (No. 1153) and Naruto Seagull Hospital (No. 16-0001).
For this type of study, formal consent is not required.
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